Month: April 2020

Children’s Hospital of Philadelphia (CHOP) has published an
excellent guide to maintaining
childhood vaccinations during the Coronavirus Pandemic. The piece warns
that current factors related to the pandemic are creating a situation in which
many children may be missed routine vaccines. This could result in a large population
of unimmunized or under-immunized children and an increase in outbreaks of
vaccine-preventable diseases (VPD).

The article continues by reporting data from the CDC on the
circulation of VPDs between January and March 2020. In addition, it lays out
solutions to continuing well child visits and routine vaccines. It ends with
resources, some of which we listed in last weeks blog post Immunization
Guidelines During COVID-19.

Be sure to check out this timely
resource to assist your practice in maintaining routine immunizations.

Today kicks off National Infant Immunization Week (NIIW), a
yearly observance of the importance of vaccinating children two years and younger.
NIIW runs April 25-May 2, 2020 as part of World
Immunization Week, a World Health Organization Initiative. NIIW highlights
major achievements in the control of vaccine-preventable diseases and brings
attention to the challenges that remain. An overview of NIIW can be found here.

The CDC’s NIIW hub provides a wide variety of resources for
healthcare professionals to use during this week. The
Digital Media Toolkit has social media messages, content, and materials for
your practice to share. These include graphics pre-sized for Facebook,
Instagram, and Twitter. In addition, the Toolkit has flyers, posters,
infographics, and videos.

Sanofi Pasteur also has a helpful resources for creating a
culture of immunization called Developing an
Immunization Culture in Your Office. This handout breaks down broad ideas
concerning immunization culture into succinct, actionable bullet points.

We hope that your practice will take some time this week to
reflect on the importance of infant immunizations and the profound impact these
vaccines have had in reducing vaccine preventable diseases. Happy National
Infant Immunization Week!

Please note that since Merck has also extended their
payment terms and prompt pay discount by an additional 30 days, invoices for
Merck vaccines purchased through VaccineShoppe or VaxServe will also carry
these same terms.

Pfizer – Effective March 26, 2020, all open invoices
dated January 1, 2020 or later for Pfizer vaccines for physicians, clinics, and
group practices will automatically have an additional 30 days payment terms
added to them. No action is required on your part. No new invoices will be
issued so we recommend you simply make note of the additional 30 days on your
current invoice. Additionally, all NEW orders for these customers placed
between March 26 and May 31, 2020 will have extended payment terms of 105 days
with the 2% prompt pay discount. Please click here
for more information.

Merck – Effective April 6, 2020, all open invoices
for Merck vaccines purchased by Physician Clinic and Physician Practice
customers through MerckVaccines.com, MerckOrders.com, or Merck Vaccine Customer Center
beginning January 7, 2020 through April 6, 2020 will have 30 days added to
their existing payment terms. No action is required on your part. A new invoice
will not be issued; therefore, we recommend you simply make note of the
additional 30 days to pay on your current invoice.

Additionally, all NEW orders placed by Physician Clinic and
Physician Practice customers on MerckVaccines.com,
MerckOrders.com, or through Merck Vaccine
Customer Center April 6, 2020 through May 6, 2020 will have an additional
30-day payment term extension, for a total of 120 days to pay.

The CDC has released updated guidelines for preventative health services for children and adults during the COVID-19 pandemic. These include guidance on providing immunizations to patients.

Children

The AAFP and AAP have joined the CDC in offering guidance on
maintaining childhood immunizations in the current pandemic. In order to
continue to immunize pediatric patients, practices should follow guidance
from the AAP on modifying clinic schedules and physical space. Recommendations
include:

Limit well visits to early morning and use the
remainder of the day for sick visits

Dedicate specific rooms for sick visits and well
visits. If a practice has multiple sites, use one location for well visits
only.

If a practice is unable to provide wells child visits for all patients in their practice, priority should be given to newborn care and vaccination of infants and young children through 24 months of age.

Adults

The American College of Physicians released a
statement on non-urgent in-person medical care on March 23. This statement
recommends the cancellation of elective and non-urgent procedures, and for
physicians to move patient care to telehealth services when possible. The CDC
recommends that adult immunizations be postponed except in two scenarios:

An in-person visit must be scheduled for some other reason and delivering preventative services during that visit will not increase risk.

An individual patient and their clinician assess that the benefit of the vaccine outweighs the risk of exposure to COVID-19.

Due to challenges related to managing the Coronavirus
outbreak, our vaccine vendor partners have made the following updates to their
ordering and payment policies:

Pfizer

Effective March 26, 2020, all open invoices dated January 1,
2020 or later for Pfizer vaccines for physicians, clinics, and group practices
will automatically have an additional 30 days payment terms added to them. No
action is required on your part. No new invoices will be issued so we recommend
you simply make note of the additional 30 days on your current invoice.
Additionally, all NEW orders for these customers placed between March 26 and
May 31, 2020 will have extended payment terms of 105 days with the 2% prompt
pay discount. Please click here for more information.

Sanofi
Pasteur

Many customers have credits accumulated on VaccineShoppe.com and can
use these credits to pay current invoices. If a particular practice or group is
in a huge bind and would like special consideration for paying invoices, they
are invited to call customer service at 1-800-VACCINE.

Merck

Effective April 6, 2020, all open invoices for Merck
vaccines purchased by Physician Clinic and Physician Practice customers through
MerckVaccines.com, MerckOrders.com or Merck Vaccine Customer Center beginning January
7, 2020 through April 6, 2020 will have 30 days added to their existing payment
terms. No action is required on your part. A new invoice will not be issued;
therefore, we recommend you simply make note of the additional 30 days to pay
on your current invoice.

Additionally, all NEW orders placed by Physician Clinic and
Physician Practice customers on Merckvaccines.com,
MerckOrders.com,
or through Merck Vaccine Customer Center April 6, 2020 through May 6, 2020 will
have an additional 30-day payment term extension, for a total of 120 days to
pay.

The Flu vaccine pre-book deadline has been extended to April
30, 2020 for those who have not yet confirmed reservations for the 2020-2021
flu season.

AstraZeneca

The pre-book deadline to reserve FluMist doses for the
2020-2021 flu season has been extended to May 31, 2020.

If there are any changes or updates to this information, we will be communicating that accordingly.

Resources to Help Address COVID-19 Challenges

We have been pulling resources together from various experts
to help you address challenges in the most financially impactful areas of
running a practice. We hope these will be helpful in managing through this
crisis:

In an emergency situation, you may need to transport
vaccinations to a secondary location. The CDC has several guides to help plan
for vaccine transport in a number of different scenarios.

Section Six (pages 22-24) of The
Vaccine Storage and Handling Toolkit provides guidance for routine
transportation, for example traveling to an off-site clinic. In these cases,
the CDC recommends transporting with a portable vaccine refrigerator with a
temperature monitoring device. However, in an emergency situation, that may not
be available. In those cases, the CDC states you can use a conditioned water
bottle transport system or, as a last resort, the manufacturer’s original
shipping container. Never use a food or beverage cooler.

The CDC’s
Guide for Transport during Emergencies contains instructions for using a
conditioned water bottle transport system. This system uses frozen and then
partially thawed water bottles to keep vaccines cool. Frozen gel packs or
coolant packs are not safe to use as they may freeze vaccines. In addition to
the water bottles, this transport method also requires insulating material such
as bubble wrap or corrugated cardboard, hard-sided or Styrofoam containers, and
a temperature monitoring device.

Due to challenges related to managing the Coronavirus
outbreak, the influenza vaccine manufacturers have extended the pre-book
deadlines for the 2020-2021 flu season:

Sanofi Pasteur – Deadline extended to April 30,
2020 for those who have not yet confirmed their reservations.

AstraZeneca – Deadline extended to May 31, 2020.

We are also working with our vaccine vendor partners to
determine what can be done to ease the vaccine-related financial burdens facing
practices at this time. Pfizer has provided the following update:

Effective March 26, 2020, all
open invoices dated January 1, 2020 or later for Pfizer vaccines for
physicians, clinics, and group practices will automatically have an additional
30 days payment terms added to them. No action is required on your part. No new
invoices will be issued so we recommend you simply make note of the additional
30 days on your current invoice. Additionally, all NEW orders for these
customers placed between March 26 and May 31, 2020 will have extended payment
terms of 105 days with the 2% prompt pay discount. Please click here for more
information.

We will communicate more as specific solutions are developed. Stay tuned!

Resources to Help Address COVID-19 Challenges

Below are some great resources we pulled together from
various experts to help you address challenges in the most financially
impactful areas of running a practice. We hope these will be helpful in
managing through this crisis:

Landlord negotiation – We are
hearing that some landlords are open negotiating rent payment during this time.
Clearly this will depend on existing contracts and relationships. Article
from the National Law Review